Date:

Name:

Address:

Creditor:

Creditor Address:

Dear ___________________:

1. Federal Fair Debt Collection Practices Act

Under the Federal Fair Debt Collection Practices Act, if I, the debtor, request that a
creditor stop calling me at home or at work, and I make such request in writing, then the
creditor must comply.

2. Written Request to Stop Calling

I am hereby requesting in writing that neither you, nor any agent on your behalf, call me
at home or at work. Do not call me at my home number, (___)___-____ or at my place of
employment at (___)___-____ .

3. Debtors Entitlement to Lawsuit

I understand and am fully aware that I am entitled to file a lawsuit against you, if you fail
to comply with this request, for $1000 in damages plus lawyers fees per occurrence. I
reserve the right to exercise these rights granted under this act.

Sincerely,